HBsAg seroclearance or seroconversion induced by peg-interferon alpha and lamivudine or adefovir combination therapy in chronic hepatitis B treatment: a meta-analysis and systematic review.
2016
Background and aims: Seroclearance or seroconversion
of hepatitis B surface antigen (HBsAg) is generally considered
as a clinical endpoint. The purpose of the present meta-analysis
was to evaluate the effect of combined therapy with pegylated
interferon alpha (PEG-IFNα) with or without lamivudine (LAM)
or adefovir (ADV) on HBsAg seroclearance or seroconversion in
subjects with chronic hepatitis B (CHB).
Methods: Randomized controlled trials performed through
May 30th 2015 in adults with CHB receiving PEG-IFNα and LAM
or ADV combination therapy or monotherapy for 48-52 weeks
were included. The Review Manager Software 5.2.0 was used for
the meta-analysis.
Results: No statistical differences in HBsAg seroclearance
(9.9% vs. 7.1%, OR = 1.47, 95% CI: 0.75, 2.90; p = 0.26)
or HBsAg seroconversion (4.2% vs. 3.7%, OR = 1.17, 95% CI:
0.57, 2.37; p = 0.67) rates were noticed between PEG-IFNα +
LAM and PEG-IFN α + placebo during post-treatment follow-up
for 24-26-weeks in subjects with hepatitis Be antigen (HBeAg)-
positive CHB.
No statistical differences in HBsAg clearance (10.5% vs.
6.4%, OR = 1.68, 95% CI: 0.75, 3.76; p = 0.21) were seen, but
statistical differences in HBsAg seroconversion (6.3% vs. 0%, OR =
7.22, 95% CI: 1.23, 42.40; p = 0.03) were observed, between
PEG-IFNα + ADV and PEG-IFNα for 48-52 weeks of treatment in
subjects with HBeAg-positive CHB.
A systematic evaluation showed no differences in HBsAg
disappearance and seroconversion rates between PEG-IFNα +
placebo and PEG-IFNα + LAM for 48-52 weeks in subjects with
HBeAg-positive CHB.
A systematic assessment found no differences in HBsAg
disappearance and seroconversion rates between PEG-IFNα +
placebo and PEG-IFNα + LAM during 24 weeks’ to 3 years’ followup
after treatment in subjects with HBeAg-negative CHB.
Conclusion: Combined therapy with PEG-IFNα and LAM or
ADV was not superior to monotherapy with PEG-IFNα in terms of
HBsAg seroclearance or seroconversion
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